Multi-level Disc Replacement in the Neck and Back

As we age, the wear and tear on our bodies can pile up — increasingly achy joints are examples of this. Another common example is degenerative disc disease (DDD), which affects more than 90% of people by the age of 60.

While DDD doesn’t always lead to symptoms, it is one of the more common causes of back and neck pain. And, in many cases, there’s more than one disc that’s leading to the discomfort.

As a leading expert in spine surgery and neurosurgery, Dr. Ali H. Mesiwala is finding success with artificial disc replacement surgery. And when more than one disc has become a liability, we turn to multi-level disc replacement.

The benefits of artificial disc replacement surgery

It used to be that the frontline surgery for disc-related back and neck pain was a decompression and fusion procedure. With this approach, the problematic disc is removed and the two vertebrae on either side are fused together.

While decompression and fusion surgery provides relief for many, there are some potential complications, including:

Adjacent segment disease (ASD)

When a cervical or lumbar disc is removed and the two vertebrae fuse together, the larger spinal segment places more pressure on the vertebrae and discs above and below the fusion site. For example, one study reports that up to 30% of people who underwent lumbar spinal fusion developed ASD within 5 years of the initial surgery.

Loss of range of motion

When two (or more) of the vertebrae in your lower back or neck are fused, your range of motion is decreased in the area.

The good news is that artificial disc replacement provides the best solution for these complications. Instead of removing your disc and fusing your vertebrae together, we replace your worn disc with an artificial one, which allows you to maintain your range of motion and it doesn't transfer the workload to adjacent areas of your neck or lower back.

To confirm why Dr. Mesiwala prefers artificial disc replacement, we want to highlight a meta-analysis of 8 studies on cervical artificial disc replacement (C-ADR) which found that C-ADR:

• Is superior to fusion for recovery and return to work
• Had higher technical success
• Had lower rates of re-operation than fusion

Our own experiences mirror these results, which is why we prefer the route of disc replacement over fusion whenever possible, at a single level and at multi levels.

Multi-level disc replacement is possible

Just as artificial disc replacement offers significant advantages over decompression and fusion with a one-level procedure, it offers the same benefits for a multi-level disc replacement.

As you might imagine, removing multiple discs and fusing multiple spinal segments only makes the complications we outline above greater. For example, a two-level cervical or lumbar fusion would reduce the range of motion even more as three vertebrae are essentially turned into one long bony structure that doesn’t offer any movement. As well, the larger piece of bone places even more pressure on the segments above and below, increasing your risks for ASD and the need for another surgery.

During a multi-level disc replacement procedure, Dr. Mesiwala removes your diseased and damaged discs and replaces them with artificial ones that perform the same functions. As a result, you retain your range of motion and there’s no added pressure on adjacent segments.

So, if you have more than one damaged disc in your back or neck that’s causing you pain, we feel it’s a good idea to explore multi-level artificial disc replacement.

To get that ball rolling, we invite you to contact one of our offices in Newport Beach, Marina del Rey, or Rancho Cucamonga, California, to set up a consultation with Dr. Mesiwala.